Nudak Ventures North Dakota LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR829 Issued in ND

Legal business name

NUDAK VENTURES NORTH DAKOTA LLC

Doing business as

NuCara Pharmacy #34

Practice address

407 Main St
Lisbon, ND 58054-4143

Phone

(701) 683-5282

Fax

(701) 683-5218

NPI assigned

Sep 6, 2006

Last updated

Aug 6, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lori Ann Willis

Title

Acquisitions Manager

Phone

(641) 366-3440

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• NuCara Pharmacy #34 Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Marie Long, PHARM.D.

  • Pharmacist
  • Lisbon, ND
  • NPI 1780275057
  NPD (past)
• Patricia Well

  • Pharmacist
  • Lisbon, ND
  • NPI 1508243106
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1265535389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "CONRAD",
            "state": "IA",
            "postal_code": "506210640",
            "telephone_number": "641-366-3440",
            "fax_number": "641-366-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 MAIN ST",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580544143",
            "telephone_number": "701-683-5282",
            "fax_number": "701-683-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUDAK VENTURES NORTH DAKOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "LORI ANN",
        "authorized_official_title_or_position": "ACQUISITIONS MANAGER",
        "authorized_official_telephone_number": "641-366-3440"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ND",
            "license": "PHAR829",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151341",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21624",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NuCara Pharmacy #34",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NuCara Pharmacy #34",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan M Nelson, DDS
• Hillary M Newborg, APRN,CNP
• Brianna Nielsen, PT
• Rebecca Maire Nord
• North Dakota Veterans Home
• Chad Allan Olson, DC
• Kiesha M. Onyeneho, MD
• Cynthia Owre
• Parkside Home (Parkside Lutheran Home, Inc.)
• Ransom County Social Services

• Community/Retail Pharmacy in Lisbon, ND
• Providers in Lisbon, ND by specialty
• Community/Retail Pharmacy in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.